As a matter of course many adoptive families have
the child undergo a comprehensive medical exam-
ination. Children adopted from other countries
often have parasitic infections and other health
conditions uncommon in the United States. FETAL
ALCOHOL SYNDROME, congenital INFECTIONwith SEXU-
ALLY TRANSMITTED DISEASES(STDS), HEPATITIS, RICKETS,
TUBERCULOSIS, and hearing loss and VISION IMPAIR-
MENTare also common, especially with interna-
tional adoptions. Though these are often treatable
conditions, they do require prompt medical atten-
tion. Children older than one year may have emo-
tional and psychologic problems as well.
Sometimes, even in a closed adoption, the inter-
mediary (adoption agency or attorney) is able to
obtain more specific health information about the
child to pass onto the adoptive parents. Conditions
that require ongoing care, such as fetal ALCOHOL
syndrome or developmental disabilities, are special
needs.
Placing a Child for AdoptionWomen have varying and often deeply personal
reasons for placing their biologic children for
adoption. Common reasons for being unable to
retain parental rights include
- serious DRUGor alcohol abuse problems
- extreme youth or immaturity
- pregnancy that was the result of rape or incest
- health or disability issues that prohibit properly
caring for a child
As well, mothers sometimes abandon their chil-
dren without known reason. A woman who
desires to place her child for adoption can notify
her doctor, a community service agency, an adop-
tion service, or an attorney. Typically there are no
expenses to the relinquishing parent. Depending
on circumstances the biologic mother may choose
the adoptive family, especially if she is pregnant at
the time she makes the decision to place the child
for adoption.
The decision to place a child for adoption,
which on the surface may appear straightforward,
has lifelong emotional consequences for mother
and child. The mother may feel guilty for “giving
up” her child. The child, when old enough to
understand what adoption means, may feel aban-
doned regardless of the circumstances of the adop-
tive family. It is important for adoptive families to
be loving yet as open as possible about questions
adoptive children may ask. Many communities
have SUPPORT GROUPSfor adoptive parents, adopted
children, and people who placed their children for
adoption. Support groups can help people share
their concerns, feelings, and solutions to common
problems.
Parenting and family are life experiences that
have challenges and accomplishments, perils and
joys, no matter what their configurations. For
many adults who adopt, adoption brings to
fruition a lifelong dream to raise and parent a
child, either starting or adding to a family. And for
many children who are adopted, adoption is daily
evidence that someone wants them and loves
them very much.
See also CULTURAL AND ETHNIC HEALTH CARE PER-
SPECTIVES; GESTATIONAL SURROGACY; PARENTING.aging, reproductive and sexual changes that
occur with The reproductive system, male or
female, is intact but immature at birth and
remains immature until the onset of PUBERTY
around age 12. Researchers do not know what
triggers the physiologic events that take place to
initiate reproductive and sexual maturity. How-
ever, these events result in the development of
SECONDARY SEXUAL CHARACTERISTICS, sex drive and
interest, and the ability to produce new life. Male
FERTILITYextends from puberty to the end of life,
though may diminish somewhat in late old age.
Female fertility is finite, starting at MENARCHE(the
onset of the MENSTRUAL CYCLE) and ending with
MENOPAUSE(the conclusion of the menstrual cycle).
Only for a few days each month is a woman capa-
ble of CONCEPTION.
The hormones of sexual and reproductive
maturity have numerous and far-reaching effects
in the body. Men and women alike have the spec-
trum of sex hormones: ESTROGENSand ANDROGENS.
Androgens dominate in men; estrogens dominate
in women. These hormones account for secondary
sexual characteristics and reproductive ability as
well as MUSCLEmass and STRENGTH, BONE DENSITY,
lipid metabolism, aspects of cardiovascular func-
tion, cognitive clarity, BRAINfunction, mood, and
emotion.242 The Reproductive System